| NPI Details | |
|---|---|
| NPI | 1083665129 |
| Gender | Female |
| Enumeration Date | 05/13/2006 |
| Last Updated | 01/23/2008 |
| Entity Type | Individual |
| Active | Over 11 years ago |
| Practice Location | |
|---|---|
| 435 S EAGLE RD EAGLE ID, 83616-6067, US |
|
| Phone | (208) 939-8200 |
| Fax | |
| Business Location | |
|---|---|
| 435 S EAGLE RD EAGLE ID, 83616-6067, US |
|
| Phone | (208) 939-8200 |
| Fax | |
| Toxanomy | |
|---|---|
| Taxonomy Code | 207Q00000X |
| License State | Idaho |
| License Number | M8876 |
| Remove 1083665129 NPI Number | |
According to our database, Nancy Mallory MD NPI is 1083665129, taxonomy code is 207Q00000X and license number is M8876, license state is located at Idaho. Nancy Mallory MD physically located at 435 S Eagle Rd, Eagle ID, 83616-6067. NPI Number Nancy Mallory MD has the Individual type.
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1083665129 NPI number is provided on an as is basis without warranty of any kind. 1083665129 is maintained by the National Plan & Provider Enumeration System. The contents of Nancy Mallory MD are for informational purposes only.
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